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Updated: Jul 10, 2025
Biomechanical Changes Related to Low Back Pain: An Innovative Tool for Movement Pattern Assessment and Treatment Evaluation in Rehabilitation
Published on: December 13, 2024
Trunk resistance to mechanical perturbations, associations with low back pain, pain-related cognitions and movement
Meta H Wildenbeest1, Henri Kiers1, Matthijs Tuijt2
1HU University of Applied Sciences, Institute for Human Movement Studies, Postbus 12011, Utrecht 3501 AA, the Netherlands; Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam 1081 BT, the Netherlands.
Background:
Pain-related cognitions are associated with motor control changes in people with chronic low-back pain (CLBP). The mechanism underlying this association is unclear. We propose that perceived threat increases muscle-spindle-reflex-gains, which reduces the effect of mechanical perturbations, and simultaneously decreases movement precision.
Aim:
To evaluate effects of CLBP and pain-related cognitions on the impact of mechanical perturbations on trunk movement, and associations between these perturbation effects and movement precision.
Methods:
30 participants with CLBP and 30 healthy controls, performed two consecutive trials of a seated repetitive reaching task. During both trials participants were warned for mechanical perturbations, which were only administered during the second trial. The perturbation effect was characterized by the deviation of the trajectory of the T8 vertebra relative to the sacrum. Trunk movement precision was expressed as tracking error during a trunk movement target tracking task. We assessed pain-related cognitions with the task-specific 'Expected Back Strain'-scale (EBS). We used a two-way-Anova to assess the effect of Group (CLBP vs back-healthy) and dichotomized EBS (higher vs lower) on the perturbation effect, and a Pearson's correlation to assess associations between perturbation effects and movement precision.
Findings:
Higher EBS was associated with smaller perturbation effects (p ≤ 0.011). A negative correlation was found between the perturbation effect and the tracking error, in the higher EBS-group (r = -0.5, p = 0.013).
Interpretation:
These results demonstrate that pain-related cognitions influence trunk movement control and support the idea that more negative pain-related cognitions lead to an increased resistance against perturbations, at the expense of movement precision.
